Superior approach for the exclusion of hepatic veins in major liver resection: A safe and easy technique |
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Authors: | Aijun Li Zeya Pan Weiping Zhou Siyuan Fu Yuan Yang Gang Huang Lei Yin Longjiu Cui Bowen Wu Mengchao Wu |
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Institution: | (1) Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, 225 Changhai Street, 200438 Shanghai, China;(2) Eastern Hepatobiliary Surgery Hospital, Shanghai, China |
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Abstract: | We describe a technique for isolating and excluding the hepatic veins during liver resection. First, the bare area near the
right and left wall of the suprahepatic inferior vena cava (IVC) is dissected, exposing the right, left, and superior walls
of the right hepatic vein (RHV) and the left-middle hepatic vein (LMHV). Two Satinsky clamps are used to clamp the roots of
the right and common trunk of the LMHV, parallel to the IVC. It is not necessary to dissect the posterior wall of the hepatic
veins. We used this method during major liver resection in 65 patients. The mean dissecting time of each hepatic vein was
7.31 ± 3.6 min. No hepatic vein was lacerated during dissection and exclusion. The postoperative complication rate was 31.2%.
Thus, the superior approach is a safe and easy maneuver when the posterior wall of the hepatic vein is difficult to dissect
due to tumor invasion.
Li Aijun and Pan Zeya contributed equally to this work. |
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Keywords: | Liver neoplasm Hepatic vein exclusion Hepatectomy Superior approach |
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